Study links earlier menopausal changes at 46 with anxiety and depression symptoms
In a Finnish birth cohort, women classified as climacteric at age 46 reported more symptoms, but the study does not show causation.
Moderate evidenceHuman studySome caution advised
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
The study used data from the Northern Finland Birth Cohort 1966, collected during participants' 46-year follow-up. Of the women included, 356, or 13%, were classified as climacteric. Anxiety and depression symptoms were assessed with two questionnaires, and medication purchases were identified through a national registry.
After adjustment for smoking, alcohol consumption, body mass index, and education, climacteric status remained associated with anxiety symptoms measured by one questionnaire and with depression symptoms measured by another. A separate depression questionnaire showed higher symptom rates before adjustment, but not an independent association after adjustment. Medication purchases were more common in unadjusted comparisons, but no independent association remained in the multivariable analysis.
What was studied
This prospective cohort study examined whether menopausal or climacteric status at age 46 was associated with anxiety and depression symptoms and with psychiatric medication purchases. It included 2,632 women from the Northern Finland Birth Cohort 1966 who attended the 46-year follow-up; 356 were classified as climacteric. Symptoms were assessed using the Hopkins Symptom Checklist-25 and the Beck Depression Inventory-21. National registry data were used to identify purchases of antidepressants and benzodiazepine derivatives. The researchers used binary logistic regression, including adjustments for smoking, alcohol consumption, body mass index, and education.
Key observations
Compared with preclimacteric women, climacteric women had significant anxiety symptoms more often: 22.6% versus 16.0%. The unadjusted odds ratio was 1.53, and it was 1.44 after adjustment for the listed factors, with a 95% confidence interval of 1.04 to 2.00.
Depression symptoms were also reported more often by climacteric women on one measure: 30.1% versus 24.6%. This association remained after adjustment, with an odds ratio of 1.39 and a 95% confidence interval of 1.03 to 1.85. A second depression measure showed rates of 17.7% versus 13.6%, but the adjusted analysis did not find an independent association.
Antidepressant purchases between ages 40 and 57 were more common among climacteric women in an unadjusted comparison, 48% versus 41%. Benzodiazepine derivative purchases were also more common, 18.3% versus 13.3%. Neither medication-purchase association remained independent in the multivariable analysis. These results are associations, not evidence that climacteric status caused the symptoms or medication purchases.
Who this is relevant to
The findings may be most relevant to women and populations similar to the Northern Finland Birth Cohort 1966 participants who were assessed at age 46. They should not be assumed to apply equally to women of other ages, populations, or menopausal circumstances. The study does not establish that climacteric status causes anxiety or depression, and it does not provide evidence about an individual person's mental-health status or medication needs.
Why this matters
The findings add human population-level information about mental-health symptoms reported by women who were classified as climacteric at age 46, a group the researchers said has been less studied. They may be relevant to understanding patterns of anxiety and depression symptoms around earlier menopausal changes, but the study does not determine the cause of those symptoms or show that the findings apply to all women.
Limitations & evidence assessment
This was an observational cohort study rather than a randomized study, so differences between the groups or other unmeasured factors could explain some or all of the associations. Symptoms were assessed with questionnaires, and medication purchases indicate dispensing or purchasing rather than necessarily confirming a diagnosis or actual use. The analysis adjusted for smoking, alcohol consumption, body mass index, and education, but the provided information does not state whether other potential influences were assessed. The excerpts also do not provide enough detail about how climacteric status was defined, participant representativeness, or losses and exclusions at follow-up. Some findings were not independent after adjustment, including the medication-purchase comparisons and the result from the second depression questionnaire.
Why this evidence level: Cohort study on humans; observational but structurally stronger than cross-sectional designs.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
Acta Obstetricia Et Gynecologica Scandinavica · 2026 · DOI: 10.1111/aogs.70358
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